Diffuse back pain and urological symptoms: recognizing tethered cord syndrome early.

Tethered cord syndrome (TCS) is a rare entity in adults, with only about 100 cases being reported in the literature. It is a syndrome in which patients have neurologic, urologic, and orthopedic signs and symptoms. We present a case of a 40-year-old man with back pain and urinary incontinence who was diagnosed with tethered cord syndrome. After the cord de-tethering in the operating room, his pain improved. TCS is an important condition to consider in the differential diagnosis of an adult who presents with back pain and urological symptoms. Imaging studies should be done, and operative treatment may be required to alleviate the symptoms. TCS should be in the differential diagnosis of any patient who presents with back and lower extremity complaints with superimposed urological problems. If TCS is confirmed radiologically by MRI, surgery can be performed with reasonable results provided that the disease process has not progressed.